Release date: 2018-06-04 Although femtosecond laser myopia surgery is immediate, its potential risks have discouraged some patients. Recently, scientists at Columbia University have proposed a method based on photochemical principles that can correct the vision of myopia patients without surgery. Its clinical trial plan will be carried out at the end of the year. Related research is published in the journal Nature-Photonics. The problem of myopia has become more serious worldwide, and it has become a major health problem that plagues human beings. As children in modern society gradually reduce their exposure to outdoor light, it is estimated that by 2020, about 2.5 billion people worldwide will suffer from myopia; by 2050, nearly half of the world’s people will be myopic, and in 2000 At the time, the proportion of myopia population is only a quarter. Myopia is particularly acute in East Asia, where 90% of adolescents in China are now myopic. Currently, one of the main means of treating myopia is refractive surgery. Refractive surgery can be immediate and effective, but it also carries a higher risk. As an invasive surgery, it may be affected by instability outside of surgery. In a rare case, the patient developed permanent blindness after surgery. In addition, laser-based vision correction procedures, such as excimer laser in situ keratomileusis (LASIK) and excimer keratectomy (PRK), still use laser ablation techniques to thin the cornea to achieve treatment. purpose. Such surgery has the potential to make the cornea more fragile. In the latest Nature Photonics, Columbia University's Sinisa Vukelic has developed a non-invasive method to permanently correct the vision of myopic patients, a method that has shown great in preclinical models. potential. Vukelic uses a technique called a femtosecond oscillator (1 femtosecond = 10^-15 seconds), which produces a laser with extremely low energy and very high oscillation frequency to selectively change the local corneal tissue. Biochemical and biomechanical properties. This method developed by Vukelic corrects vision by altering the macroscopic geometry of the corneal tissue, which produces a low-density plasma in the focal region, but whose energy is insufficient to destroy the tissue in the treated area. Therefore, patients do not need surgery and have fewer side effects and limitations than corneal surgery. For example, patients with thinner corneas, dry eye, and other eye diseases cannot undergo corneal surgery. This study is expected to completely cure eye diseases such as myopia, hyperopia, and astigmatism. "Our research should be the first to use this special laser to non-invasively alter corneal curvature, or to treat other clinical symptoms," Vukelic said. He is currently a lecturer in the Department of Mechanical Engineering at Columbia University. “We can observe low-density plasma in multi-photo imaging, which is often seen as an undesirable side effect,†Vukelic said. “We are now turning this side effect into a new way to improve the mechanical properties of keratinous tissue. method." Corneal morphology before and after treatment (left), and simulated visual effects (right) The key point of the method proposed by Vukelic is that the introduction of a low-density plasma leads to the ionization of water molecules in the cornea. The ionization process produces reactive oxygen species (an unstable molecule that readily reacts chemically with other molecules in the cell) that react with keratin proteins to form chemical bonds or chemical crosslinks. When Vukelic applies this method to the cornea, the introduction of chemical crosslinks changes the properties of the corneal tissue at the target, ultimately leading to changes in the macrostructure of the entire cornea. The principle of this therapy is to ionize the target molecules in the cornea, thereby avoiding optical damage to the corneal tissue. Since this is a photochemical process, it does not cause tissue disorders, and the efficacy can be maintained. "If we carefully adjust these changes, we can change the curvature of the cornea and change the refractive power of the eye," Vukelic said. "This treatment is completely different from the current mainstream femtosecond laser therapy, which relies mainly on the target organization. Optical breakdown and subsequent formation of bubbles." “Refractive surgery has been under development for several years, and although it is now a mature technology, the field of myopia treatment is still looking for a simpler, less invasive alternative,†Colombia, who did not participate in the study. Leeejee H, associate professor of the University Medical Center. Suh said, "Vukelic's innovative therapies are very promising. This is likely to be a major breakthrough in the field of myopia treatment, which will cure more myopia patients." The Vukelic team plans to launch clinical trials at the end of the year. He is also looking for ways to predict corneal mechanical behavior through the function of laser radiation, such as using a laser to illuminate a small circular area of ​​the cornea, a function that will give the cornea how it will deform. If researchers can predict the mechanical behavior of the cornea, they can introduce a "personalized" therapy that scans the patient's cornea and then uses Vukelic's algorithm to design a therapy for each patient. “What's especially exciting is that our approach is not limited to eye treatment, it can also be used for other keratin-rich tissues,†Vukelic added. “We are currently working with Professor Gerard Ateshian's lab to try This method is used to treat osteoarthritis. The preliminary results are very good. We believe that this non-invasive therapy has great potential and it opens the way to non-destructive repair of keratinous tissue." Source | Columbia University Translation | Li Changhao Review | Wu Fei Original paper: Femtosecond laser crosslinking of the cornea for non-invasive vision correction Source: Global Scientific Scientific American WeChat Public Number
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